Are you having problems in the bedroom? A sex therapist might help. But how do you know if you really need to see a professional? Here are 8 clues. Plus, learn how to choose the right therapist…

Stacie H., 32, seems to have it all. She’s beautiful, married to a doctor and loves her job as a substitute teacher. But, she confesses, “I don’t like sex."

Even outside of the bedroom, Stacie admits she’s not affectionate with her husband.

“I just don’t think to do it," she says. "Then my husband says, ‘You haven’t touched me in weeks.’ I feel so bad.”

So Stacie consulted a sex therapist to improve her love life.

“I realized that I can’t do this on my own,” she says. “I want an amazing marriage.”

Calling in a Specialist When the issues hanging you up are largely sexual, it helps to have a professional in your corner.

“If you’re having the same fights about sex or find yourself saying ‘I’m just not going to have sex anymore,’ you need somebody to step in,” says Ellen Barnard, a sex educator and co-founder of the women’s boutique A Woman’s Touch (A-Womans-Touch.com) in Madison, Wisc.

“Sex therapists strip away your baggage,” Barnard says. “They take you into the origins of your sexual experiences and attitudes and help you undo them so you can move forward.”

The American Association of Sexuality Educators, Counselors and Therapists (AASECT) estimates that about half of all couples have an intimacy issue at some point in their relationship that could benefit from sex therapy.

How do you know if your sex life could use professional help? Read on for 8 tip-offs.

1. You’re never in the mood. After your 20s or the first blush of a new relationship, no one’s always in the mood for sex. But if you used to crave it regularly and have recently developed a “take-it-or-leave-it” attitude, a sex therapist can help you figure out how to get your groove back.

“It’s normal to have ebbs and flows of desire,” says P. Michele Sugg, an AASECT-certified sex therapist in Branford, Conn. “The real indicator is whether it’s bothering you and how long it’s lasted.”

2. You don’t have orgasms.About 70% of women don’t experience orgasm through intercourse alone. But if you’ve never had one, a sex therapist will determine what's causing the problem and suggest ways to help you relax so you can.

3. You argue about how much sex is “enough.”Whenever one partner wants sex more often than the other – and it's not just women who make excuses; guys do it too – someone will feel pressured and the other unfulfilled. And that means conflict. A sex therapist can help referee.

4. Your partner doesn’t satisfy you.Maybe you need some coaching in how to tell your partner what you want. Or if he has some mechanical issues, take him to see a doctor. Erection difficulties can indicate heart disease or diabetes.

But don’t underestimate the power of psychological issues – fear of pregnancy or STDs, insecurities about his body or his abilities as a lover.

5. You were taught that sex is shameful.Even nowadays, when everyone discusses everything from oral sex to vibrators, the childhood messages we first received about sex can surface unexpectedly. Sex is shameful. Oral sex is disgusting. The list of shouldn’ts is endless. Or perhaps you’ve got a quirk that does the trick, but with significant guilt.

“A lot of people feel guilty about things they shouldn't,” says sex therapist Stephanie Buehler, Psy.D., director of the Buehler Institute in Irvine, Calif. “It’s worth it to talk with a professional and get some perspective.”

6. You’ve had a life-altering trauma.

Maybe you were assaulted. Perhaps you had a life-threatening or disfiguring surgery, such as a mastectomy after breast cancer. Although you came through, you feel disconnected from your sexuality and need help reconnecting.

7. Intercourse is painful, even impossible.

Occasional discomfort with sex isn’t unusual. About 2% of women experience vaginismus, an involuntary spasm of the vaginal muscles that literally locks things up, often making penetration impossible.

The reasons vary. Sexual assault can be a factor. So can a lifelong litany of abstinence messages.

“I’ve had young women tell me, ‘I’ve heard Good girls don’t, and now I can’t because my body has taken care of that,’” Barnard says.

A sex therapist can work on the psychological component – reframing negative messages about sex – and recommend specific exercises to help vaginal muscles relax.

8. One partner has a sexual compulsion.

“There’s a price paid - the possibility of arrest, divorce, losing your job,” explains Dennis Sugrue, Ph.D., clinical associate professor of psychiatry at the University of Michigan Medical School in Ann Arbor. “One of the core characteristics is the [sexually compulsive] person feels that they don’t have control of their behavior," he says. "They keep telling themselves, I’m going to stop, only to find themselves right back at it.”

One common scenario: A woman discovers her husband is avoiding sex with her to spend time on adult websites.

“That creates a tremendous conflict, and they end up in my office,” Sugrue says.

What Happens in Sex Therapy?

First, sex therapy does NOT mean you have sex in the therapist’s office.

“I had one client who was afraid that I was going to stand with a clipboard and watch her and her husband making love,” Buehler says. Any sex the therapist recommends, you’ll do it at home, in private, by yourself or with your partner.

In the therapist’s office, you'll talk about your sexual history and background, whether you (or anyone close to you) ever experienced sexual trauma, and the messages and information you got about sex from your family, peers or religion.

Much of therapy is education or re-education, Sugrue says. “People often operate with misinformation about what’s normal and how their bodies work."

Therapists also help identify and revise any self-defeating beliefs - like you're a freak if you like something kinky - “so you don’t become your own worst enemy in a sexual situation,” Sugrue says.

“Sex therapy could be a one-time conversation that just reassures you that you’re normal,” he says.Because sexual issues affect both partners, the therapist will include your spouse some of the time, though therapy can also be done solo.

“That validates that you’re facing the issue together, and it gives [therapists] the opportunity to resolve issues and strengthen the relationship, sexually and non-sexually,” Sugrue says.

Your therapist might also prescribe “homework": reading The Joy of Sex or a book on specific topics, such as vaginismus, or watching erotic DVDs.

“When you’re busy and stressed, you may need help getting aroused,” Barnard explains. “A lot of people struggle with this issue when they schedule sex because we’re taught that it's supposed to be spontaneous.”

Sex therapists might also prescribe nonsexual massages that uncover how you and your partner like to be touched without the pressure of sex. Or they might recommend experimenting with vibrators to help with orgasm difficulties or relaxation exercises to reduce the anxiety of sexual dysfunction.

However, because sexual problems aren’t always all in your head, most sex therapists will advise you to see your doctor to determine if there’s a medical cause – low hormone levels, blood flow problems, depression, or a medication side effect – for the dysfunction.

Choosing a Therapist

Look for a licensed mental health professional, one with at least a master’s degree as a marriage/family therapist, counselor or clinical social worker, as well as training in couples therapy. (Psychologists and psychiatrists can also specialize in sex therapy.)

Only the state of Florida requires that sex therapists be certified, so check into their training to be sure they've done more than read the Kama Sutra.

Organizations like AASECT and the American Board of Sexology (sexologist.org) can provide referrals to licensed, certified sex therapists.

Once you’ve found a therapist, ask about the issues they treat. Some therapists offer general sex counseling; others specialize in women’s issues, such as low desire or men’s issues like rapid ejaculation.

Ask how they include partners in the treatment and when you might see results. After all, therapy isn’t cheap – it ranges from $90-$200 an hour – so you want to know you’ll make progress.

Also, chat with the therapist on the phone or do a trial session to find out if you feel comfortable with them. You’re going to be sharing private information, so chemistry is key. If it’s not a good fit, don’t be afraid to try someone else.

“Every therapist knows not every client is a match,” Buehler says. “It’s OK to say, ‘I think I need a different therapist.’”

The bottom line: We’re built to enjoy sex, so there’s no need to be stuck.

“Any issue is workable if the partners want to work on it,” Sugg says. “When people seek help, and they’re motivated, things will get better.”

Should You See a Sex Therapist?Never in the mood? Unsatisfied in the bedroom? Got intimacy issues? Constantly fighting with your partner about sex or its nonexistence? Your sex life may benefit from some professional help. Take our sex therapist quiz to find out.

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